| NPI | 1891796728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI NP04374) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH NPO4374) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: OH RN096301) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2019-08-12 |